Pelvic Relaxation/ Vaginal Prolapse

What is it?
Pelvic relaxation/vaginal prolapse is caused by weakness of the “pelvic floor."  The pelvic floor is a sheet of muscle and connective tissue that stretches from the pubic bone to the tailbone. The pelvic floor surrounds and supports the vagina, rectum, bladder and urethra. When the pelvic floor is weakened, these pelvic organs cave into the vagina (pelvic relaxation) or even through the opening of the vagina (vaginal prolapse). The exact cause of vaginal prolapse is unknown. Some risk factors for the development of prolapse are vaginal delivery, hysterectomy, repeated heavy lifting and chronic constipation or coughing.         

Types of vaginal prolapse:

• An anterior vaginal wall prolapse (also called “cystocele” or “fallen bladder”) is the relaxation of the vaginal wall that supports the bladder.
• A posterior vaginal wall prolapse (also called “rectocele”) is the relaxation of the vaginal wall that supports the rectum.
• Uterine prolapse is the descent of the uterus into the vaginal canal.
• Apical prolapse (also called “vault prolapse” or “enterocele”) is the descent of the top of the vagina (where the uterus was removed during a hysterectomy) into the vaginal canal. 

Symptoms:

• A bulge at the opening of the vagina
• Pelvic pressure, heaviness, or discomfort
• Difficulty emptying the bladder or rectum
• A sensation of looseness or obstruction with intercourse

Treatment options:

• Pelvic Floor Physical Therapy - pelvic floor physical therapy includes a regimen of four or more visits with a female physical therapist with specialized training in strengthening the pelvic floor. This will not decrease the extent of prolapse but may help prevent worsening of the prolapse.
• Vaginal Pessary - a vaginal pessary is a device worn in the vagina to support pelvic organ prolapse. A “pessary fitting” includes two or more office visits in which a healthcare provider helps you find a type and size of pessary that will work best for you.
• Surgery - minimally invasive surgery is available to repair vaginal prolapse. Surgery is most often done vaginally and usually requires a one night hospital stay. The type of surgery will be chosen based on what part of the vagina has prolapsed.

Click here to download a printable version of the pelvic relaxation/vaginal prolapse handout.